Urgent endovascular ligature of a ruptured splenic artery pseudoaneurysm in a patient with acute pancreatitis: a case report

J Med Case Rep. 2015 Jan 9;9(1):6. doi: 10.1186/1752-1947-9-6.

Abstract

Introduction: We report on the successful endovascular treatment of a ruptured splenic artery pseudoaneurysm. Our patient had acute pancreatitis superimposed on chronic calcific pancreatitis and chronic renal impairment. Contrast-enhanced ultrasonography was used to assess post-embolization results.

Case presentation: Our patient was a 67-year-old white Caucasian man with recurrent pancreatitis. Computed tomography angiography showed a pancreatic pseudocyst with a ruptured pseudoaneurysm, which was successfully embolized using an endovascular percutaneous approach. At six months, persistent renal failure led to contrast-enhanced ultrasonography. This confirmed the absence of turbulent blood flow and extravasation of contrast medium in the pseudocyst.

Conclusion: Our experience with this case leads us to support the role of interventional radiology as a first-line treatment tool. Contrast-enhanced ultrasonography can be used to follow-up embolization procedures in patients with impaired renal function.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, False / diagnostic imaging*
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy
  • Aneurysm, Ruptured / diagnostic imaging*
  • Aneurysm, Ruptured / therapy
  • Angiography
  • Embolization, Therapeutic / methods*
  • Humans
  • Ligation
  • Male
  • Pancreatitis / complications
  • Pancreatitis, Chronic / diagnosis*
  • Pancreatitis, Chronic / physiopathology
  • Pancreatitis, Chronic / therapy
  • Radiology, Interventional
  • Splenic Rupture / complications
  • Splenic Rupture / diagnostic imaging*
  • Splenic Rupture / therapy
  • Treatment Outcome
  • Ultrasonography, Doppler, Color